Tuesday, July 12, 2016

On MSNBC on Martin Luther King Day, Governor Rick Snyder was asked whether environmental racism had anything to do with the Flint water crisis. His response was “Absolutely not. Flint is a place I’ve been devoted to helping.”

In fact, environmental racism has everything to do with it, the Governor’s clean conscience notwithstanding, and every Michigander needs to understand how it does so we can understand the problems of our struggling cities as well as our poor rural areas.

A very popular narrative about the problems of Flint, Detroit and other Michigan cities goes something like this: These communities were economically ravaged by their voters who elected leaders who they knew would finance unsustainable contracts, payrolls and benefits, and now that the party is over and the cities are bankrupt, regular, hardworking Michiganders are being stuck with the tab. This is often thinly concealed code for “Black people create problems that White people have to clean up”.

A similar narrative is increasingly being used to describe the poor, rural (mostly White) areas of Michigan where despair is leading to sharp increases in suicide, drug abuse, chronic disease and rising overall mortality rates—and where hope of economic recovery is vanishing. I described these chilling trends in the first part of this series. Stereotypes that poor, rural Michiganders are self-destructive slackers who deserve their fate are growing stronger.

Before I come back to what's happening in our rural areas, I’m going to pose an alternative history of Flint, one that blames environmental racism for the crisis. I will do so in a very personal way. I’m going to tell a story about my family. I’m going to talk about my two grandfathers. These two men loved me a great deal, and gave many gifts to our family. Strangely, one of the most influential things that came to me from them happened because my parents made an effort to learn about our family’s attitudes and behaviors toward Black people. Because of my parents’ efforts and what I learned about my grandfathers, I have a strong, personal sense how White Americans limited the economic opportunities of Black Americans, laying the foundations for the disaster in Flint.

My father’s father, Richard, who had an eighth grade education, rose to become a vice-president of his Mississippi town’s bank. In the 1950s, like virtually all White people in his town, he actively participated a social system that systematically crushed the aspirations of Black people. He became a prominent member of the White Citizen’s Council, the organization that worked to maintain school segregation and prevent Blacks from voting. In 1955, the White Citizens' Council published in the local paper the names of 53 Black signers of a petition for school integration. Soon afterward, the petitioners lost their jobs and had their credit cut off. Richard was deeply involved in a notorious incident in which the first Black social worker hired in the area was fired as a warning to other Black professionals. He wasn’t the worst person to have walked the earth, but the fact that he was my grandfather makes me understand that White racism is part of my family’s legacy in this country.

In the middle of the 20th century, in the Great Migration, Black people fled the South to get away from people like my father’s father. They moved to places like Flint, and also Oakland, California. Unfortunately, there they ran into people like my mother’s father, Herbert.

Herbert was an architect and conservationist who lived in Oakland. But, like almost all White people of his generation, he was also a segregationist. In the mid-fifties, almost all White American home owners agreed to discriminate against Blacks and Jews by not selling their homes to them, doing their part in the cluster of practices known as “red-lining”. Real estate associations, city planners and federal government policies on financing home ownership excluded minorities as part of their official policies. When he purchased his home in Oakland, Herbert signed a memorandum stating that he would not sell to a Black person or Jew. The foothills remained almost exclusively White until near the end of the 20th century while the flatland seethed in poverty.

So Blacks fled the South to get away from racists and came to places like Flint or Oakland where they ran into segregation. In their new homes they often did not get the best jobs, were the first fired when globalization devoured industrial jobs starting in the 1980s, and were never able to buy good homes. Most never acquired wealth. When the economy of Flint imploded, the well-to-do fled, but the poor, many of whom were Black, were left without the means to sustain themselves or their community. When the tax base collapsed so did the capacity of the government.

But many aspects of this story are actually strikingly similar to the recent history of rural Michigan. This story has been told for Montcalm County, one of the places in which I work today, in an award-winning documentary. In Montcalm, divisions in the community fell along social class rather than racial lines. But these divisions meant that some residents did not acquire wealth in the form of valuable property, even though Montcalm had both prosperous agriculture and industrial sectors. Then globalization shuttered most of the factories in the area right around the turn of the 21st century. Many of the residents tumbled from what felt like the middle class into poverty. What had once been a landscape of family farms and factory jobs became a landscape of factory farms and rural slums. I believe this was the beginning of the trends that led to the spiraling health problems we saw in the first part of this series. And, similar to Flint, the erosion of the tax base in Montcalm has led to drastic reductions in government services threatening the ability of residents to protect themselves and their health.

I am writing about this because I have noticed during conversations about race in Mid-Michigan, that feelings about racial justice are often used as reasons to deny social justice to rural Michiganders. Feelings about racial justice can block action on problems facing rural communities. For example, you may hear people say that we can’t create a potentially beneficial social program that could help rural Michiganders (this was used as an objection to the expansion of Medicaid), because of the risk that undeserving [Black?] people could possibly benefit from it. Sometimes people seem to worry more about their fears of others milking the system then about putting policies in place that would truly promote health and well-being. But of course an objective reading of history shows that neither urban, mostly Black Michiganders, nor rural, mostly White Michiganders created their circumstances. They were both victims of forces beyond their control and they can’t move forward without progressive policies designed to hem in the power of the wealthy and create new opportunities for the majority. Pitting people against each other just blocks changes that would improve lives and holds everyone back.

I started this three part series with a disturbing tour of statistics showing increasing mortality rates in rural areas. I have tried to show that these trends make sense when you realize rural Michigan is subject to the same kinds of social forces that have affected other rural areas like Appalachia, but also urban parts of Michigan, like Flint. We used the story of pollution in St. Louis, Michigan and the economic collapse of Montcalm County to illustrate this point. My hope is that Michiganders will one day see that we all share an interest creating the conditions that promote health and well-being for everyone, and will seize every opportunity to do so.

Monday, July 11, 2016

In my last blog post I showed that northern and central Michigan has a lot in common with the coal country of Appalachia in terms of mortality due to chronic disease, drug overdoses and suicides: that is, we are among the worst places for those killers in North America. The problems are so severe that for low-income Whites mortality rates are actually rising for the first time ever.

I do not claim to understand fully why this is happening, but one concept that may be useful is that of environmental justice. The concept of environmental justice seeks to explain why health problems are concentrated in some places. It says that in some places there are imbalances in power so large that people cannot successfully advocate for themselves. Coal country is a good example. People in
Appalachia were so dependent on the coal industry for jobs that they could not successfully demand safe working conditions, reasonable compensation and a clean environment. They were never able to diversify their economies so that when the coal industry declined and jobs disappeared families were wiped out and the tax bases of communities collapsed.

Communities where there are high levels of environmental injustice tend to have three characteristics:

Dependency. Residents are economically dependent on a powerful industry and are forced to tolerate abuses to survive.

Powerlessness. Efforts to demand justice are unsuccessful because of the imbalances in power.

Voicelessness. When residents speak out or try to tell their story they are told they are wrong or ridiculed.

The concept of environmental justice is often applied to post-industrial cities with large communities of color like Flint, Michigan. Flint is the city in which a government-appointed emergency manager changed the water supply to save money (good idea) without ensuring that it was treated it properly (bad idea), resulting in widespread exposure to lead. In Flint people were dependent on the auto and other manufacturing industries which began to collapse under pressure from globalization in the 1980s. Housing segregation was either legal or tolerated right into the 1970s, meaning African-Americans in Flint did not acquire wealth in the form of valuable homes at nearly the same rate as Whites. When the economy collapsed, those who could afford to do so moved, leaving mostly vulnerable low-income people behind.

The tax base shrank setting the stage for the water disaster. Why did it take the Genesee County Health Department 18 months to figure out there was lead in the water? The Department’s budget and staff had been more than cut in half meaning the community was powerless to protect itself. The residents of Flint were virtually voiceless even though the protested loudly that there was something wrong with the water. During the run up to the disaster I was in a meeting with a DEQ official who told me people in Flint didn’t know what they were talking about. “They keep showing up at meetings with bottles of brown water. The water is brown because it has iron in it! But they won’t listen!” He called Dr. Mark Edwards who had data that proved there was lead in the water a “Kook” and heads nodded.

Are there rural communities with widespread environmental injustice in central and northern Michigan? It is easy to think of examples. Towns in the Upper Peninsula were dependent on iron and copper mining, for example. But I’ll write about what I know: the environmental disaster in St. Louis, Michigan in the geographic heart of the Lower Peninsula.

Beginning in the 1930s the Michigan Chemical Company produced a variety of chemicals on the banks of the Pine River in St. Louis, including DDT and a flame retardant PBB. It was widely known as a very dirty business, encouraging employees not to worry about exposure to toxics, and dumping waste in the river and several sites in the community. But people were dependent on the company and so it got away it. In 1978 PBB was accidently mixed into animal feed that was shipped to cattle, hog and chicken facilities throughout Michigan. When Michiganders consumed meat, milk or eggs they were exposed to the PBB. Many farm families who ate their own animals became very ill. Today Michiganders who are tested are still found to have PBB levels six times higher than the national background level.

When farmers complained that something was making their cattle sick they were told there was nothing wrong, or that it must be due to their own bad farming practices. Later when the real extent of the problem was discovered Michigan Chemical was allowed to pay a small settlement, and bury the plant site under a clay cap. People in St. Louis complained that the company should be forced to pay for a clean-up but they were powerless to influence the government’s decisions, and the company was allowed to leave the state without doing so. A few years later residents discovered that the clay cap was leaking but their voices were ignored until it was found that PBB and DDT levels in the river were actually continuing to rise. Finally, forty years after the PBB was mixed into the animal feed the EPA declared Super Fund sites in St. Louis and began working on remediation.

Urban, mostly Black Flint, and rural, mostly White St. Louis share some unfortunate traits. They have been dependent on industries that didn’t love them back, they have been powerless to influence decisions about their fates, and when they tried to speak out their voices were not heeded. They share some other things too: both culminated in environmental disasters that have been incredibly expensive to clean up and both ruined the reputations of moderate republican governors who wanted to leave legacies as environmentalists but weren’t willing to put the systems in place that would truly protect the environment (Milliken for St. Louis, Snyder for Flint).

With this kind of history to unite us, Michiganders should band together to fight for environmental justice, but often we don’t. Often we feel like we are pitted against each other. Can that change? I witnessed something recently that says maybe it can, at least for some of us. At a community meeting at Alma College I saw this exchange between two people who I will call Bob and Betty (not their real names). Bob burst out with “So these people in Flint don’t take care of themselves, and they mess up their water supply, and now other people like me are supposed to pay millions of dollars to bail them out?” Betty turned to Bob and put her hand on his arm and said, “Bob, when you talk that way it makes me sad. Remember, we have been working for decades to get the government to pay millions of dollars to clean up our mess, and now they are finally, and we are glad, and people in Flint are paying their share of that, too.” Bob thought a minute and said, “Thank-you Betty, you are right.”

I managed to go on for hundreds of words here talking about Flint without really talking about race. In my next blog post I am going to write at length about how race influences our thinking about environmental justice, including in rural areas.

Sunday, July 10, 2016

I want to kick off a set of three blog posts that explore the causes of some of our most serious public health problems. Today I want to look at alarming trends in health in rural Michigan and ask what is happening to us? What I will do in the next two posts is ask whether rural Michigan is a victim of the same kind of forces that cause public health crises in other rural areas like Appalachia, but also in some urban areas, like Flint.

I’m going to show you three maps. The maps show the distribution of some serious health problems in the Midwest. What you will see is that rural central and northern Michigan is in trouble. In fact we look like some of the sickest parts of North America. What you will also see is that even though the maps represent different public health problems, the distribution is the same in each case. This provides evidence about what those forces causing our public health crisis might be.

This map is from a well-known analysis of the distribution of heart disease deaths originally done by the CDC and reproduced many, many times. First notice the legend. The disparity in heart disease deaths is enormous. The places with the highest rates of heart disease death (red) have rates eight times higher than those with the lowest (white)! Then look at northern Michigan. Excluding the prosperous communities around Grand Traverse and Charlevoix, northern Michigan tends to have high heart disease mortality rates.

I do not understand why, but Minnesota and Wisconsin, which I think of as being similar to us, fare much better. But look at big cluster of mortality centered on Kentucky and West Virginia; our heart disease death rates are like theirs.

The next map is of the opioid overdose death rate, again from the CDC. Opioids include prescription painkillers and illegal drugs like heroin.

Opioid overdoses have recently shot up in some rural areas, especially in Kentucky and West Virginia, and also in northern Michigan. Opioid use has been identified as a risk factor in the spread of HIV in rural areas. Again, Minnesota and Wisconsin seem to be spared. New York is spared also, because of policies ensuring access to drugs that aid in recovery from addiction.

The last map is of the gun suicide rate (sorry about the poor quality reproduction). It was made by the digital magazine Braid using CDC data. Suicides have increased sharply in some parts of rural North America. Again we see the same pattern, with northern Michigan, Kentucky and West Virginia having very high rates and other places being lower. My conclusion: Northern Michigan has something in common with coal country!

These problems—chronic disease, drug abuse and suicide—are part of a cluster of health problems befalling low-income, rural communities in some parts of North America that are so severe, they are actually causing measurable increases in the overall mortality rate. For background on that look here and here.

And these unprecedented mortality rate increases are happening in low-income, rural parts of Michigan. You can see it at the local level. This line chart is for Montcalm County but you get the same results in many counties in Michigan.

The chart shows the heart disease death rate; the blue line is for Montcalm. For years heart disease death rates had been trending down locally just like everywhere else in North America due to reductions in smoking and improvements health care, but in the past few years the trend locally has reversed.

There are many factors that are contributing to rising mortality rates. Some of these factors, like stagnating rural economies, involve complex public policy and political issues. Other factors, like the pushing of opioids by pharmaceutical companies, are specific and narrow. But low-income, rural communities seem especially vulnerable and are being hit harder than other areas. In my next two blog posts I want to explore why they are so vulnerable.